You may have heard the adage, “every face tells a story.” Scars can also tell stories, even when you want to keep those stories to yourself.
Many people feel self-conscious about extensive scarring. That’s why so much effort and research has been poured into scar removal techniques. However, people whose scars are the result of deliberate self-injury may find it particularly difficult to cope with their old wounds.
Many go to lengths to cover these scars and fear judgment for them. This what can make self-harm scars so debilitating: it’s not the scars themselves, but the constant worry that those scars will act as a signal to the rest of the world — a big flashing billboard that advertises your history of depression, anxiety, or self-destructive tendencies.
Of course, what matters most is managing these scars when they are upsetting to you personally, and possibly preventing you from closing a chapter in your life.Fortunately, there are now a wide variety of scar removal and treatment options available.
In this article, we’ll discuss finding the best option for you personally, and highlight some of the more popular methods being used to treat and cover old self-inflicted scars.
Listen to your doctor, not the blogs
If you’ve been doing your research on self-harm scar removal, you’ve probably heard that techniques like dermabrasion and laser scar removal are ineffective against self-inflicted scars. You may have also read that significant scar revision or removal is impossible, and that you have little choice but to resort to medical tattooing (a technique we’ll address in more detail later) in order to permanently disguise them.
It is true that dermabrasion is more useful for lighter scars, such as those resulting from acne or minor injuries, and does little to address the keloid or hypertrophic scars which tend to result from self-injury. However, remember that everyone’s scarring is going to be unique.
Which procedure works best for you will depend on the size, amount, and location of your scars. Always consult with a plastic surgeon before writing off a technique or surgical treatment. You may find yourself pleasantly surprised at the number of options available to you.
The following techniques may or may not be right for you. However, they are among the latest and most popular methods, making them as good a place as any to start thinking about the new you.
Blend your scars with medical tattooing
When we talk about “tattooing,” we’re not talking about colorful sleeve tattoos to hide your scars — although some people do go that route. Instead, this refers to the use of color in the skin to blend the scars in with your natural complexion.
Medical tattooing starts with microneedling, also known as Collagen Induction Therapy (CIT). This popular scar relaxation technique uses tiny needles that repeatedly puncture the skin. It’s similar to getting a tattoo, except without any ink. The procedure is intended to induce collagen production, hence it’s name. As such it can reduce the appearance of scars, softening them up and blending them in with the skin.
Medical tattooing for scar revision, also known as micropigmentation, is basically microneedling with a little pigment added to the mix. The pigment is matched to your skin tone and injected into the scar tissue. This will in no way remove the scars, but it should make them less visible.
Micropigmentation doesn’t work overnight. Scars might appear red at first, actually making them more visible. However, with time the color fades and the scars blend in. It’s also sometimes necessary to have more than one session to ensure the best results. Luckily, recovery is easy and most people are able to resume their normal activities after no more than 24 hours.
According to Ruth Swissa, a certified medical micropigmentation (CMM) expert based in Beverly Hills, micropigmentation should only be performed by an experienced professional who understands how the skin’s undertones will blend with the tattoo pigment to achieve natural, long term results. This requires artistry and strong technical skills.
If you are considering medical tattooing to improve the appearance of your scars, working with a CMM expert is widely recommended.
Use fat transplantation to smooth out skin
This procedure requires a somewhat lengthier recovery period. However, if your scars are textured, especially if they are depressed, a fat transplant will smooth out your skin, and make them less noticeable.
Fat transplants, sometimes also called fat transfers or fat grafting, are exactly what they sound like: fat is taken from one part of your body, processed and cleaned, then injected into another part of your body. In this case, the fat is injected into scars. This typically results in fuller and smoother looking skin.
As your own fat is being used for the procedure, there is little to no risk of an allergic reaction. However, the procedure is not without its potential negative side effects. You may experience bruising, swelling, and bleeding. In the worst case scenario, while unlikely, you could develop an infection or abscess.
The bruising may last for several days and the swelling several weeks after that. It’s difficult to pin down an exact recovery time for fat transplants because your post-operative instructions and healing process will depend on the location and size of the injection sites.
Surgically remove the scars from your body
If you think that this sounds a little extreme, you’re not wrong. Although there are some variations in how this procedure is performed, the basic idea remains the same: the scars are treated with steroid injections before being removed entirely, along with a portion of surrounding and underlying skin. Your own skin is then harvested from another part of the body and grafted onto the treated area.
In a 2005 study published by the Journal of Plastic and Reconstructive Surgery, Dr. Cengiz Acikel, a professor of aesthetic plastic and reconstructive surgery who practices in Istanbul, Turkey, explains his innovative take on this technique.
It involves the removal of the uppermost part of the scarred area using a laser or a dermabrasion device. The raw surface is then covered with a thin (0.2 mm) skin patch harvested from the thigh region.
The animation below shows the results of this procedure (Credits: Dr. Cengiz Acikel).
This method may not be for the faint of heart, but could be just what someone with severe scarring is looking for. Over time, scarring from the actual skin graft becomes significantly less noticeable than the dozens of smaller self-inflicted scars it can replace.
A 2012 study details how a group of patients who underwent a similar treatment benefited from its outcome:
“Scars were excised from the forearm en block, removing the majority of the affected area. Simultaneous use of a single layer skin substitute was used, covered by an autologous split-thickness skin graft. Negative pressure wound therapy was then applied immediately for two weeks after surgery. Results: The original scars were successfully converted to a socially and cosmetically acceptable appearance.”
Sometimes, doctors choose to use artificial skin grafts for this purpose. In one 2008 study, doctors evaluated the efficacy of Integra, a skin graft substitute made from cow collagen proteins and shark cartilage. Artificial skin grafts, of which Integra is the most widely used, reportedly result in less scarring after the fact. This might make them more appealing to those looking to rid themselves of the evidence of their self-harm. However, little is known about the long-term effects of this method, as it has not been around as long as traditional skin grafting.
Skin grafting is the most invasive of the procedures mentioned in this article, and comes with the lengthiest recovery time. Typically, a skin graft should be coddled for approximately two to three weeks. In other words, don’t bump, stretch, or scratch it. A bandage may need to be worn for over half of this recovery period.
It’s also best to avoid getting skin grafts wet until your doctor says otherwise, and important to note that, unless you’re using an artificial graft, a skin graft will leave you with two wounds: one where the skin was grafted, the other at the donor site. Both sites need to be well cared for and result in a certain degree of scarring.
This is by no means a quick fix for those in need of scar revision as it could take months for skin grafts to start looking their best. However, the results are long-lasting and will continue to look better with time.
Healing the skin – Healing the Soul
It is important to note that board-certified plastic surgeons will not operate on individuals who are still self-harming and will likely insist that the scars be fully healed before performing many of these procedures.
When it comes to self-harm, there is more to consider than just the scarring. If you struggle with self-mutilation or suicidal thoughts, speak with a counselor and seek the help of a certified mental health professional.
The National Suicide Prevention Lifeline is one of many organizations that provide free and confidential support at any time for those in crisis. Their number is 1-800-273-TALK (8255).
Remember, healing the body is only one element of the overall healing process.
- Camouflage of Self-Inflicted Razor Blade Incision Scars with Carbon Dioxide Laser Resurfacing and Thin Skin Grafting (2005) ncbi.nlm.nih.gov/pubmed/16141818
- Successful Resurfacing of Scars from Previous Deliberate Self-Harm Using Integra Dermal Matrix Substitute (2008) ncbi.nlm.nih.gov/pubmed/17409041
- Todd, J., Ud-Din, S., & Bayat, A. (2012). Extensive self-harm scarring: successful treatment with simultaneous use of a single layer skin substitute and split-thickness skin graft. Eplasty, 12, e23. ncbi.nlm.nih.gov/pmc/articles/PMC3359068